Verrucae Treatment
Verruca is a complex treatment case but can respond very well to laser therapy. In terms of effectiveness, in a properly controlled 1996 double blind trial, 60% of verrucae cases were resolved as opposed to 17% in the placebo group. Laser therapy is no less effective overall than any other treatment but equally will not be fully successful in every case. However, it has a number of advantages over alternative treatments and no symptomatic disadvantages. It can also be beneficially used in conjunction with cryo-surgery.
Not only is the treatment pain-free but it actually delivers pain relief, is non-invasive and is without unpleasant side effects, making it particularly well received by patients. There is never tissue damage or scarring. In fact, it can help reduce scarring from previous treatments. Laser therapy does not rely on patient compliance, other than appointment attendance, with no post-treatment complications and it is ideal for the treatment of children and nervous patients.
The number of treatments required varies case by case, with some resolving in one session but others requiring, at the extreme, 10 treatments.
I have been using Low Level Laser Therapy (LLLT) with good effect for treating verrucae (warts), trigger point pain, sports and soft tissue injuries, reloma durum with fibrous tissue involvements and post nail surgery. I presented a paper on LLLT at the 1999 2nd Unified Podiatry Conference in Dublin, and am currently carrying out a clinical research study into the treatment of lesions caused by the Human Papilloma virus.
Pat Turnball - Podiatrist, Cheshire UK
History
Female who had suffered eleven years of mosaic verrucae, not improved by previous treatments which included regular debridement, topical caustics, three sessions of cryosurgery and hypnotherapy. Patient was a shop worker and pain was interfering with ability to work.
Treatment
Dose: 8 J/cm2 on 5 points per treatment
Wavelength(s): Multiple – see equipment for 46 cluster specification
Probe: 46 Cluster
Frequency/intervals: 2 treatments over 2 weeks.
Outcome
Pain reduced from 6 to 2 on VAS after first treatment. After 4 weeks: no pain (0 VAS) and no VP tissue detectable with 10x hand lens.
Clinician
Dr Warren Turner, University of Derby
Verrucae Pedis: Evaluation of a method of eradication using class 3B (low level) Laser Therapy – A Double blind Clinical Study. Warren A Turner Bsc (Hons) DPodM MChS lecturer, then of Northampton School of Podiatry, now of University of Derby.
Sample: 54 patients between 12- 40 yrs with lesions less than 18 months old.
A study was carried out over a twelve week period to investigate the effectiveness of low level laser therapy on a sample of patients with verrucae pedis lesions. 27 subjects with verrucae underwent irradiation with low level laser. 19 (70%) of these subjects were free of verrucae at the end of the study period. The mean time taken for lesion resolution was 6 weeks of twice weekly visits. Low level laser therapy would appear to be a painless, effective form of treatment for plantar warts, with none of the unpleasant side-effects of other therapies, the real benefit of LLLT as a treatment for verrucae is that no long term harmful effects were noted in any of the subjects receiving it.
| Wavelength | Power | Energy Density | Power Density | Energy Per Point | Pulses |
| 660nm |
15mW | 3.6/Jcm2 |
0.12W/cm2 |
0.45 J |
20KHz |
Turner W.A. Veruccae Pedis: Evaluation of a method of eradication using class 3B (low-level) laser therapy – a double blind clinical study. Unpublished (submitted in 2002 to American Society of Lasers in Surgery & Medicine).
A preliminary pilot study in the use of Low Power Laser as a non-invasive technique for the treatment of plantar warts and verrucae. (1991) Vicki Burrows M.C.S.P., S.R.P.,BWT Charterd Physiotherapists, Poole ,UK. Dr Mary Dyson and Dr Salah el Sayed, Dept odf Anatomy, Guys Hospital, The use London UK. Omega Research Laboratories, London,UK. Presented to The Fifth International Biotherapy Laser Association Meeting, Royal Free Hospital.
The use of a class 3b laser in the treatment of common warts and verrucas: A case study (2001) Julie Holliday. Unpublished.
The Efficacy of Laser Surgery for Verruca Plantaries: Report of a Study. Lawrence A Lavery BS - Dr William M Scholl College of Podiatric Medicine, Chicago, Illinois. Johnathon M Cutler BS, Dr William M Scholl College of Podiatric Medicine, Chicago, Illinois. Adolph W Galinski DPM, American Board of Podiatric Surgery, Dept of Surgical Sciences Dr William M Scholl College of Podiatric Medicine, Chicago, Illinois. Bart W Gastwirth DPM, American Board of Podiatric Orthopedics, Dr William M Scholl College of Podiatric Medicine, Chicago, Illinois.
Omega holds copies of research studies not yet published.